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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Cholecystectomy
What is a cholecystectomy?
A cholecystectomy is a surgical procedure in which the
doctor removes your gallbladder and its contents. About
500,000 Americans undergo cholecystectomy every year.
Removal of the gallbladder should cause few, if any,
long-term problems because the digestive system can function
normally without it.
When is it used?
The gallbladder is shaped like a balloon and holds bile.
Bile is produced in the liver and helps with digestion of
foodstuffs in the intestinal tract. Particles in the bile
may form gallstones. These stones can remain loose in the
gallbladder, block the gallbladder, get stuck in the common
bile duct, or pass into the intestine. If the stones plug
the gallbladder neck, the flow of bile is partially blocked.
When the gallbladder contracts it can cause abdominal pain.
It may become swollen, infected, and/or start to decompose.
Examples of alternatives to cholecystectomy include:
- to dissolve the stones chemically
- to remove the gallbladder with a laparoscope and a laser
or electrocautery
- to crush the stones with sound waves (lithotripsy)
- to choose not to have treatment, recognizing the risks of
infection, jaundice, pain, and bursting of the
gallbladder.
You should ask your doctor about these choices.
How do I prepare for a cholecystectomy?
Plan for your care and recovery after the operation. Allow
for time to rest and try to find people to help you with your
day-to-day duties.
Follow any instructions your doctor may give you. Eat a
light meal, such as soup or salad, the night before the
procedure. Do not eat or drink anything after midnight and
the morning before the procedure. Do not even drink coffee,
tea, or water.
What happens during the procedure?
A general anesthesia is given. It will relax your muscles
and make you feel as if you're in a deep sleep. It will
prevent you from feeling pain during the operation. The
doctor makes a cut in your abdomen and finds the gallbladder
and the cystic duct (the tube from the gallbladder to the
common bile duct). Then the gallbladder and part of the
cystic duct are removed. The doctor may check for and
remove any gallstones found in the common bile duct.
What happens after the procedure?
You will stay in the hospital for 1 to 6 days, based on
your condition. You may be very sore for 4 or 5 days, and
somewhat sore for up to 4 weeks. Because the intestines
recover slowly, you cannot eat normally for the first
several days after the operation and will be fed
intravenously. After this time, you can return to a normal
diet. The doctor may place a tube through a small cut to
drain bile for several days after the operation. Avoid all
strenuous activity, such as lifting, for 4 to 6 weeks.
Ask your doctor what other steps you should take and when
you should come back for a checkup.
What are the benefits of this procedure?
You should no longer have pain associated with the effects
of gallstones and remove the risk of developing an infection
or jaundice.
What are the risks associated with this procedure?
- There are some risks associated with general anesthesia.
Discuss these risks with your doctor.
- The common bile duct or other nearby organs could be
injured.
- The wound may become infected, requiring the doctor to
open it again and place a drainage tube in the cut or
give you drugs, perhaps an antibiotic.
- There is a risk of bleeding.
You should ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
- You develop a fever.
- You have unusual abdominal pain.
- Your wound becomes reddened, warm, or begins to drain
fluid.
- You feel nauseated.
- You vomit.
Call the doctor during office hours if:
- You have questions about the procedure or its result.
- You want to make another appointment.
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